Thanks, Annie. That is very sensible advice. I would really rather not make the trip (as I'm sure you understand! It will be _all_ I do that day), but it will be well worth it to get a response without alienating my doctor. And yes, I did notice the Valentine's Day connection! Should I bring him some cookies?

I am not being offered IVIG. My symptoms just aren't severe enough, I guess. My choices are Imuran, Cellcept, or Prednisone, and the doctor and I agree that unless I start having trouble breathing, or start falling, or something like that, it would be better to avoid the Prednisone. So I chose Imuran. I'm aware of the risks.

My paternal grandparents both died of cancer, but my maternal grandparents lived into their late 80s, and my parents are both alive (in their late 60s). I inherited an over-active immune system from my mother and her mother--germs are afraid of us (I can't remember the last time I had a cold). And we have autoimmune diseases (Graves' throughout, and my mother had extremely severe atopic dermatitis, cured finally by UV light treatment). It has crossed my mind that Imuran treatment might not only put me in MG remission (because my case is relatively mild) but also cure my Graves'--and perhaps even prevent future autoimmune diseases like MS.

But, my neuro's not happy about starting Imuran on me, since he thinks I'm of child-bearing years and he's worried about birth defects, if I conceive unintentionally. I found studies showing that the risk is tiny or non-existent, but all he sees is that it's a Pregnancy Category D drug. I also found studies showing that at my age--almost 45--the chances of conceiving are miniscule, even if I were not trying not to! So I think his concerns are unwarranted. That's what the hold-up is about. But if he's still not willing to consider the Imuran, maybe he would consider the IVIG after all--and maybe that's a better option for me anyway. Though with Imuran, I have the hope of remission, but not with IVIG, right? The Boston neuro said that (maybe because my case is relatively mild) it's "very likely" that the Imuran will put me in remission within a few years.

Abby